Clinical Outcomes of Ketamine Therapy for Depression, Anxiety, and PTSD in Post-TBI Patients
W. Aldulaimy, A. ShahIntroduction
TBI patients often suffer from severe, treatment-resistant depression and PTSD. Ketamine shows promise in non-TBI populations, but its efficacy in TBI patients needs exploration for efficacy and tolerability.
Objectives
Evaluate ketamine’s clinical effectiveness and safety (PHQ-9, GAD-7, PCL-5 scores) in post-TBI patients, comparing IM, intranasal, and oral routes.
Methods
Design: Retrospective chart review of 35 adult TBI patients (mean age 38.4; TBI 3.5 years prior).
Formulations: IM (0.5-0.75 mg/kg), Intranasal (84 mg esketamine), and Oral Dissolving Tablets (100-300 mg).
Measures: PHQ-9, GAD-7, and PCL-5 scores.
Analysis: Efficacy by % reduction, response (≥50% reduction), and remission (PHQ-9 < 5, PCL-5 < 20).
Results
Magnitude: Large effect sizes observed (32.7% GAD-7/ODT to 65.6% PCL-5/Nasal). Clinical: 72% response, 45% remission rates. Route-Dependent: Parenteral (IM/Nasal) outperformed ODT due to better bioavailability. Rapid Onset: Initial improvement within 5-10 days. Safety: Favorable profile with mild, transient adverse events.
Conclusions
Magnitude: Large effect sizes observed (32.7% GAD-7/ODT to 65.6% PCL-5/Nasal). Clinical: 72% response, 45% remission rates. Route-Dependent: Parenteral (IM/Nasal) outperformed ODT due to better bioavailability. Rapid Onset: Initial improvement within 5-10 days. Safety: Favorable profile with mild, transient adverse events. 1. Directions
Disclosure of Interest
None Declared